CARN (ADDICTIONS NURSE) – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Pharmacology and Pharmacokinetics of Substances• Assessment and Diagnosis of Substance Use
Disorders• Nursing Interventions and Treatment Planning• Management of Acute Withdrawal and Medical
Complications• Co-occurring Psychiatric and Medical Disorders• Ethical, Legal, and Professional Issues in
Addictions Nursing• Prevention, Education, and Health Promotion• Therapeutic Relationships and
Communication
INTRODUCTION
The Certified Addictions Registered Nurse (CARN) assessment is designed to rigorously evaluate the clinical
expertise and specialized knowledge required for professional practice in addictions nursing. This
comprehensive exam covers the full spectrum of care, from foundational neurobiological theories to advanced
clinical interventions for individuals across the lifespan. By utilizing a mix of knowledge-based and complex
scenario-based multiple-choice questions, the assessment ensures that candidates possess the critical thinking
skills necessary for real-world decision-making. The focus remains on evidence-based practice, patient safety,
and the ethical management of substance use disorders within diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A patient is admitted for acute alcohol withdrawal. Which of the following neurotransmitters is primarily
responsible for the central nervous system hyperexcitability seen during this period?
A. Dopamine
B. Gamma-aminobutyric acid (GABA)
🟢 C. Glutamate
D. Serotonin
🔴 RATIONALE: Chronic alcohol consumption suppresses glutamate (an excitatory neurotransmitter) activity.
Upon cessation, the brain experiences a "rebound" effect of glutamate overactivity, leading to tremors,
,tachycardia, and seizures.
2. A nurse is caring for a pregnant patient with opioid use disorder (OUD). Which medication is considered
the gold standard for stabilizing the intrauterine environment and preventing withdrawal?
A. Naloxone
🟢 B. Methadone
C. Naltrexone
D. Disulfiram
🔴 RATIONALE: Methadone or Buprenorphine is recommended for OUD during pregnancy to prevent the
cycles of intoxication and withdrawal that are harmful to the fetus.
3. Which of the following is the most appropriate initial nursing action for a patient presenting with suspected
Wernicke’s encephalopathy?
🟢 A. Administration of Thiamine (Vitamin B1)
B. Administration of high-glucose IV fluids
C. Orientation to person, place, and time
D. Referral to a long-term rehabilitation center
🔴 RATIONALE: Thiamine must be administered immediately to prevent permanent neurological damage
(Korsakoff’s psychosis). Glucose should not be given before thiamine as it can exacerbate the condition.
4. A patient prescribed Disulfiram (Antabuse) must be educated to avoid which of the following substances?
A. Acetaminophen
B. Caffeinated beverages
🟢 C. Alcohol-based hand sanitizers and mouthwash
D. Dairy products
,🔴 RATIONALE: Disulfiram causes a severe physical reaction when combined with even small amounts of
alcohol, including that found in topical products or hygiene items.
5. According to the ASAM criteria, which dimension specifically assesses the patient’s readiness to change?
A. Dimension 1
B. Dimension 2
C. Dimension 3
🟢 D. Dimension 4
🔴 RATIONALE: Dimension 4 of the American Society of Addiction Medicine (ASAM) criteria focuses on
"Readiness to Change," evaluating the patient's stage of change and internal motivation.
6. During a motivational interviewing session, a patient says, "I know I drink too much, but it's the only way I
can deal with my boss." This is an example of:
🟢 A. Sustain talk
B. Change talk
C. Paradoxical intention
D. Cognitive reframing
🔴 RATIONALE: Sustain talk refers to the patient’s speech that favors staying the same or justifies the current
substance use behavior.
7. Which screening tool is specifically designed to identify high-risk drinking in pregnant women?
A. CAGE
🟢 B. T-ACE
C. AUDIT
D. DAST-10
, 🔴 RATIONALE: The T-ACE is a validated 4-item screening tool specifically modified for use in prenatal
settings to identify risky drinking.
8. A patient in the emergency department has pinpoint pupils, respiratory rate of 6, and is unresponsive.
What is the priority nursing intervention?
A. Draw a blood alcohol level
B. Check the patient’s temperature
🟢 C. Administer Naloxone
D. Insert a Foley catheter
🔴 RATIONALE: These are classic signs of opioid overdose (respiratory depression, miosis, coma). Naloxone
is the opioid antagonist required to reverse these life-threatening symptoms.
9. In the neurobiology of addiction, the "reward pathway" is primarily located in which area of the brain?
A. Prefrontal cortex
B. Cerebellum
🟢 C. Nucleus accumbens and Ventral tegmental area
D. Occipital lobe
🔴 RATIONALE: The Mesolimbic Dopamine System, specifically the nucleus accumbens and VTA, is central to
the brain's reward and reinforcement mechanisms.
10. A nurse is reviewing a patient's lab results and notices an AST:ALT ratio of 2:1. This is a common
biochemical marker for:
🟢 A. Chronic alcohol use disorder
B. Opioid toxicity
C. Methamphetamine abuse
D. Benzodiazepine withdrawal
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Pharmacology and Pharmacokinetics of Substances• Assessment and Diagnosis of Substance Use
Disorders• Nursing Interventions and Treatment Planning• Management of Acute Withdrawal and Medical
Complications• Co-occurring Psychiatric and Medical Disorders• Ethical, Legal, and Professional Issues in
Addictions Nursing• Prevention, Education, and Health Promotion• Therapeutic Relationships and
Communication
INTRODUCTION
The Certified Addictions Registered Nurse (CARN) assessment is designed to rigorously evaluate the clinical
expertise and specialized knowledge required for professional practice in addictions nursing. This
comprehensive exam covers the full spectrum of care, from foundational neurobiological theories to advanced
clinical interventions for individuals across the lifespan. By utilizing a mix of knowledge-based and complex
scenario-based multiple-choice questions, the assessment ensures that candidates possess the critical thinking
skills necessary for real-world decision-making. The focus remains on evidence-based practice, patient safety,
and the ethical management of substance use disorders within diverse healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A patient is admitted for acute alcohol withdrawal. Which of the following neurotransmitters is primarily
responsible for the central nervous system hyperexcitability seen during this period?
A. Dopamine
B. Gamma-aminobutyric acid (GABA)
🟢 C. Glutamate
D. Serotonin
🔴 RATIONALE: Chronic alcohol consumption suppresses glutamate (an excitatory neurotransmitter) activity.
Upon cessation, the brain experiences a "rebound" effect of glutamate overactivity, leading to tremors,
,tachycardia, and seizures.
2. A nurse is caring for a pregnant patient with opioid use disorder (OUD). Which medication is considered
the gold standard for stabilizing the intrauterine environment and preventing withdrawal?
A. Naloxone
🟢 B. Methadone
C. Naltrexone
D. Disulfiram
🔴 RATIONALE: Methadone or Buprenorphine is recommended for OUD during pregnancy to prevent the
cycles of intoxication and withdrawal that are harmful to the fetus.
3. Which of the following is the most appropriate initial nursing action for a patient presenting with suspected
Wernicke’s encephalopathy?
🟢 A. Administration of Thiamine (Vitamin B1)
B. Administration of high-glucose IV fluids
C. Orientation to person, place, and time
D. Referral to a long-term rehabilitation center
🔴 RATIONALE: Thiamine must be administered immediately to prevent permanent neurological damage
(Korsakoff’s psychosis). Glucose should not be given before thiamine as it can exacerbate the condition.
4. A patient prescribed Disulfiram (Antabuse) must be educated to avoid which of the following substances?
A. Acetaminophen
B. Caffeinated beverages
🟢 C. Alcohol-based hand sanitizers and mouthwash
D. Dairy products
,🔴 RATIONALE: Disulfiram causes a severe physical reaction when combined with even small amounts of
alcohol, including that found in topical products or hygiene items.
5. According to the ASAM criteria, which dimension specifically assesses the patient’s readiness to change?
A. Dimension 1
B. Dimension 2
C. Dimension 3
🟢 D. Dimension 4
🔴 RATIONALE: Dimension 4 of the American Society of Addiction Medicine (ASAM) criteria focuses on
"Readiness to Change," evaluating the patient's stage of change and internal motivation.
6. During a motivational interviewing session, a patient says, "I know I drink too much, but it's the only way I
can deal with my boss." This is an example of:
🟢 A. Sustain talk
B. Change talk
C. Paradoxical intention
D. Cognitive reframing
🔴 RATIONALE: Sustain talk refers to the patient’s speech that favors staying the same or justifies the current
substance use behavior.
7. Which screening tool is specifically designed to identify high-risk drinking in pregnant women?
A. CAGE
🟢 B. T-ACE
C. AUDIT
D. DAST-10
, 🔴 RATIONALE: The T-ACE is a validated 4-item screening tool specifically modified for use in prenatal
settings to identify risky drinking.
8. A patient in the emergency department has pinpoint pupils, respiratory rate of 6, and is unresponsive.
What is the priority nursing intervention?
A. Draw a blood alcohol level
B. Check the patient’s temperature
🟢 C. Administer Naloxone
D. Insert a Foley catheter
🔴 RATIONALE: These are classic signs of opioid overdose (respiratory depression, miosis, coma). Naloxone
is the opioid antagonist required to reverse these life-threatening symptoms.
9. In the neurobiology of addiction, the "reward pathway" is primarily located in which area of the brain?
A. Prefrontal cortex
B. Cerebellum
🟢 C. Nucleus accumbens and Ventral tegmental area
D. Occipital lobe
🔴 RATIONALE: The Mesolimbic Dopamine System, specifically the nucleus accumbens and VTA, is central to
the brain's reward and reinforcement mechanisms.
10. A nurse is reviewing a patient's lab results and notices an AST:ALT ratio of 2:1. This is a common
biochemical marker for:
🟢 A. Chronic alcohol use disorder
B. Opioid toxicity
C. Methamphetamine abuse
D. Benzodiazepine withdrawal
